BACKGROUND: The analgesic efficacy and safety of transdermal fentanyl patch(TDFP) combined with intravenous ketorolac administration were evaluated. METHODS: TDFP releasing 75 mcg/h (Group 1) or 50 mcg/h (Group 2) or placebo (Group 3) were applied to 60 women at 2 hours before abdominal gynecologic surgery. Postoperatively, patients self-administered intravenous ketorolac as required using patient controlled analgesia. Each group was assessed following 48 hours with respect to vital signs, VAS pain score, satisfaction score, side effects, and cumulative ketorolac use. RESULTS: After operation, pain score and ketorolac demand were significantly lower and satisfaction score and side effects were significantly higher in TDFP group (Group 1, 2) than control group (Group 3). CONCLUSIONS: If TDFP is applied 2 hour before surgery, combined with a bolus dose of 200 mcg i.v. fentanyl at induction of anesthesia and ketorolac i.v. infusion in the postoperative period, it provides a significant degree of background analgesia without respiratory depression.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia ; Female ; Fentanyl* ; Gynecologic Surgical Procedures ; Humans ; Hysterectomy* ; Ketorolac* ; Postoperative Period ; Respiratory Insufficiency ; Vital Signs

BACKGROUND: The purpose of this study was to evaluate the effect of different doses of fentanyl and morphine on the spread of spinal analgesia produced by bupivacaine. METHODS: 40 patients undergoing arthroscopy or transurethral resection under spinal anesthesia were randomly assigned to receive intravenous 50 or 100 g of fentanyl(F-50, F-100) or 5, 10 mg of morphine(M-5, M-10). 10 min after, we assessed the new levels of analgesia and administered intravenous naloxone 0.4 mg. The levels of sensory analgesia was reassessed 10 min after naloxone. RESULTS: 10 minutes after intravenous opioids, the level of analgesia increased significantly in M-10 group compared with F-50, M-5 group. Naloxone antagonized the effect of opioids on spinal analgesia. CONCLUSIONS: We conclude that systemic opioids enhance the spread of analgesia in a dose dependent manner, and this enhancement was antagonized by naloxone.
Analgesia* ; Analgesics, Opioid ; Anesthesia ; Anesthesia, Spinal ; Anesthetics ; Arthroscopy ; Bupivacaine ; Fentanyl* ; Humans ; Morphine* ; Naloxone

This study was performed to investigate the effect of vitamin C and E supplementation on blood pressure, plasma lipids, folate, and homocysteine levels in smokers and non-smokersof college male students in Gyeonggi Area. The nutrient intakes were determined by a 24hr-recall method. The subjects were divided into six groups: vitamin C supplementation group (n: smokers = 10, nonsmokers = 10), vitamin E supplementation group (n: smokers = 10, nonsmokers = 10), vitamin C and E supplementation group (n: smokers = 10, nonsmokers = 10), respectively. There were no significant differences between the smokers and nonsmokers in terms of anthropometric measurements. Systolic and diastolic blood pressure were significantly higher (p < 0.05) in smokers than that of non-smokers. There was no significant difference in energy and other nutrients intakes between smokers and non-smokers. In plasma lipids levels, smokers had higher plasma triglyceride, LDL-cholesterol, VLDL-cholesterol, total cholesterol concentration than that of non-smokers (p < 0.05). HDL-cholesterol level of smokers had a tendency to be lower than that of nonsmokers. In smokers, AI, TPH, LPH were significantly higher than that of non-smokers (p < 0.01). Plasma folate, homocysteine levels were not significantly different between smokers and non-smokers. The effect of antioxidant vitamins supplementation in smokers: In vitamin C supplementation group, HDL-cholesterol level was significantly increased (p < 0.01) and AI, TPH, LPH were significantly decreased (p < 0.01). In vitamin E supplementation group, HDL-cholesterol level was significantly increased (p < 0.05). In vitamin C and E supplementation group, LPH was significantly decreased (p < 0.05). The effect of antioxidant vitamins supplementation in non-smokers: HDL-cholesterol level was significantly increased (p < 0.05) and AI, TPH, LPH were significantly decreased (p < 0.05) by vitamin C supplementation group. Plasma homocysteine level was decreased by vitamin E supplementation group in non-smokers p < 0.01). The results of this study showed that smoking had a tendency to increase plasma lipids levels that factor into the risk of coronary heart disease. It is considered that antioxidant vitamin supplementation in smokers had a tendency to decrease cardiovascular disease than in nonsmokers.
Ascorbic Acid ; Blood Pressure* ; Cardiovascular Diseases ; Cholesterol ; Coronary Disease ; Folic Acid* ; Gyeonggi-do* ; Homocysteine* ; Humans ; Male ; Plasma* ; Smoke ; Smoking ; Triglycerides ; Vitamin E ; Vitamins*

Purpose: This study was conducted to examine the results of designing and implementing a teaching program for medical education as the elective course for 4th-year students of medical course. Methods: In order to design the teaching program for medical education as an elective course, we conducted literature review, five medical education experts were interviewed, and the literature required in the design process was reviewed. A developing teaching program was implemented as an elective course in a medical school of Korea, and 4th-year students of medical course participated in the program. Results: In the elective course, the medical education program process competencies were derived into three categories: theoretical educational knowledge, teaching competency, and research competency for education. Moreover, instructional materials were developed to help students achieve these competencies. And project-based learning strategy was selected and implemented for 4th-year students in medical course, and positive satisfaction was confirmed. Conclusion As a study designed and implemented in a medical education program in a medical school in Korea, it is expected to be helpful when introducing medical education to undergraduate students or developing a medical education program to strengthen the teaching capacity of residents.

The currently available coronavirus disease 2019 (COVID-19) vaccines in South Korea include mRNA (Moderna® and Pfizer®) and adenoviral vector (AstraZeneca® and Janssen® ) vaccines. Dermatologic side effects of COVID-19 vaccines range from local injection site reactions to systemic eruptions, including morbilliform rashes or erythema multiforme. Pernio-like lesions, one of the most common cutaneous manifestations of COVID-19, have been rarely reported post-vaccination. Herein, we report four cases of pernio-like lesions, which were detected in a single tertiary hospital within 2 months, after the first dose of mRNA-1273 (Moderna® ) vaccination was administered. In this study, we discuss the clinical and pathological features of our cases and compare them with those of previously reported cases of pernio-like lesions after COVID-19 vaccination. It is pivotal to realize that perniolike lesions can be a possible side effect of COVID-19 vaccination and that the number of patients experiencing this side effect is bound to be quite high in real-world clinical settings.

OBJECTIVES: This study was conducted in order to determine the validity and reliability of the Korean version of the Barratt Impulsiveness Scale-11-Revised (K-BIS-11-R) in Nonclinical Adult Subjects. METHODS: The K-BIS-11-R was tested in non-clinical (n=270) native Korean-speakers. Internal consistency reliability was calculated using Cronbach's alpha and test-retest reliability was measured using Pearson correlations. To see external validity, we performed confirmatory factor analysis for determination of whether the three-factor model, proposed by the previous report, fit the data. RESULTS: According to the results, the K-BIS-11-R had an acceptable test-retest reliability and internal consistency reliability. In addition, the K-BIS-11-R total score and second-order subscale score showed significant correlation with Conners' Adult attention deficit/hyperactivity disorder Rating Scale-Korean and Buss & Durkee Hostility Inventory. In addition, no significant difference was observed between the K-BIS-11-R total score and demographic variables. Thus, the K-BIS-11-R total score was transformed to standard score. CONCLUSION: K-BIS-11-R is a reliable and valid measure and has possible utility for assessment of impulsiveness in nonclinical adult subjects. Further research is needed in order to determine the cutoff score for administration of K-BIS-11-R to clinical adult subjects.
Adult ; Factor Analysis, Statistical ; Hostility ; Humans ; Reproducibility of Results

OBJECTIVES: This study aimed to evaluate the healing rate of non-surgical endodontic treatment between C-shaped and non-C-shaped mandibular second molars. MATERIALS AND METHODS: Clinical records and radiological images of patients who had undergone endodontic treatment on mandibular second molars between 2007 and 2014 were screened. The periapical index scoring system was applied to compare healing outcomes. Information about preoperative and postoperative factors as well as the demographic data of the patients was acquired and evaluated using chi-square and multinomial logistic regression tests. RESULTS: The total healing rate was 68.4%. Healing rates for the mandibular second molar were 70.9% in C-shaped canals (n = 79) and 66.6% in non-C-shaped ones (n = 117). The difference was not statistically significant. CONCLUSIONS: The presence of a C-shaped canal in the mandibular second molar did not have a significantly negative effect on healing after treatment. Instead, proper pulpal diagnosis and final restoration were indicated as having significantly greater influence on the healing outcomes of C-shaped and non-C-shaped canals, respectively.
Dental Pulp Cavity* ; Diagnosis ; Humans ; Logistic Models ; Molar* ; Retrospective Studies*

OBJECTIVES: This study was conducted in order to determine the validity and reliability of the Korean Version of the Conners Adult ADHD Rating Scales-42 items & 26 items (K-CAARS-42 & K-CAARS-26) in nonclinical adult subjects. METHODS: The K-CAARS-42 & K-CAARS-26 was tested in non-clinical (n=270) native Korean-speakers. Internal consistency reliability was calculated using Cronbach's alpha and test-retest reliability was measured using Pearson correlations. To see validity, we performed the confirmatory factor analysis for determination of whether the four-factor model fit the data. RESULTS: The results showed that the subscales had acceptable internal consistency reliability and high test-retest reliability ; and the second-order scores showed significant correlation with the Korean version of the Barratt Impulsiveness Scale-11-Revised and Prospective and Retrospective Memory Questionnaire. The Confirmatory factor analysis revealed a four-factor structure of both K-CAARS-42 and K-CAARS-26. CONCLUSION: The K-CAARS-42 & K-CAARS-26 is reliable and has possible utility for symptom assessment of attention deficit and hyperactivity disorder in nonclinical adult subjects. Further research is needed in order to determine the cutoff score for administration of the K-CAARS-42 & K-CAARS-26 to clinical adult subjects.
Adult* ; Attention Deficit Disorder with Hyperactivity* ; Factor Analysis, Statistical ; Humans ; Memory ; Prospective Studies ; Surveys and Questionnaires ; Reproducibility of Results* ; Retrospective Studies ; Symptom Assessment

OBJECTIVE: To find factors associated with dysmenorrhea, we surveyed the obstetric and gynecologic histories as well as socioeconomic factors of Vietnamese female residents in Can Tho (southern part of Vietnam) and Bavi (northern part of Vietnam) and Vietnamese female marriage immigrants living in South Korea. METHODS: From March 2010 to March 2011, 3,017 Vietnamese women aged 17 to 42 years (mean, 25.5 years) were recruited. Socioeconomic factors as well as baseline characteristics, including gynecologic history and menstrual patterns, were collected using questionnaires. The relationships between these factors and dysmenorrhea were analyzed using chi-square test, independent t-test and logistic regression analysis. RESULTS: Dysmenorrhea was found in 58.8% of all women. The mean age and the age at menarche were younger in the women with dysmenorrhea. A longer duration of menstrual flow and severe menstrual volume increased the risk of dysmenorrhea. The prevalence of dysmenorrhea was lower in women who had experienced pregnancy, term delivery and breastfeeding. The prevalence of dysmenorrhea in Vietnamese women was also different according to their educational status. When participants were divided according to their religious preferences, atheist women showed a lower prevalence with 55%, and women who were religious had a higher prevalence of dysmenorrhea. The body mass index, menstrual cycle length, monthly income, and duration of residency in Korea were not related with the prevalence of dysmenorrhea. CONCLUSION: Socioeconomic factors as well as age, menstrual pattern and obstetric history were related with dysmenorrhea in Vietnamese women.
Aged ; Asian Continental Ancestry Group ; Body Mass Index ; Breast Feeding ; Dysmenorrhea ; Educational Status ; Emigrants and Immigrants ; Female ; Humans ; Internship and Residency ; Korea ; Logistic Models ; Marriage ; Menarche ; Menstrual Cycle ; Pregnancy ; Prevalence ; Surveys and Questionnaires ; Republic of Korea ; Socioeconomic Factors

PURPOSE: Radiocontrast media are widely used in medical imaging to improve diagnostic accuracy. However, studies on the adverse reactions of radiocontrast media in children are limited. We aimed to describe the characteristics of adverse reactions to radiocontrast media among children who had a computed tomography scan or magnetic resonance imaging in a tertiary university hospital. METHODS: We retrospectively collected data on adverse reactions to radiocontrast media by the reporting system of a tertiary university hospital. We selected data from children under the age of 19 from July 2011 to December 2017 and analyzed their characteristics. We focused mainly on the characteristics of the index case which is defined by the first adverse event of each subject. RESULTS: During the period, a total of 88,050 radiocontrast media-enhanced imaging studies were performed and 184 cases of adverse reactions were reported. A total of 71 were identified as index cases. Forty-nine (69.0%) were male and the mean age was 12.7±3.2 years. The incidence of radiocontrast media-related adverse reactions was 0.09% and severe reactions were 0.002%. The most common clinical feature was skin manifestations (54.9%), followed by gastrointestinal symptoms (40.8%) and neuropsychiatric symptoms (7.4%). CONCLUSION: Adverse reactions to radiocontrast media rarely occur in children and the incidence of severe reactions is low. Most reactions are mild and are related to the skin and gastrointestinal system. This report would provide good evidence for establishing a management strategy in children scheduled for imaging studies using radiocontrast media.
Child* ; Contrast Media* ; Diagnostic Imaging ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Skin ; Skin Manifestations